1. Field
This invention relates generally to valved manifold devices, and is specifically directed to such devices in medical conduit systems. It provides a valved manifold particularly useful at the patient intubation interface of endotracheal ventilation/aspiration systems.
2. State of the Art
Many gas delivery systems, particularly in a hospital or laboratory environment, utilize manifold devices for directing fluid flow. There are a variety of circumstances in which it is necessary or desirable to provide multiple, yet isolated, other pathways through the interior of such a manifold. The manifold is often associated with other components as a system. When the individual components of such a system are subjected to mechanical forces tending to rotate one component with respect to another, it is often essential to provide that travel path through a joint structure which permits rotating or swiveling movement.
As an example, closed systems for endotracheal suctioning and ventilating typically include a manifold enabling introduction of ventilating gases and intermittent exhalation of patient breath simultaneously with insertion and operation of a tracheal suctioning catheter. The manifold structure typically includes multiple ports, usually the open ends of respective conduits extending from a common chamber. One such port is interfaced to a patient through a patient connection device. The suction catheter is often included within an assembly which is connectable to a second port of the manifold. The catheter assembly conventionally includes a collapsible plastic envelope positioned to entirely surround the catheter. A practitioner manually externally collapses the envelope onto the external surface of the catheter and advances the catheter through the manifold into an access tube connected to a patient, retracting the catheter in a similar fashion following the aspiration procedure.
The manifold thus provides a first pathway for ventilation gases and a second pathway for the catheter. The catheter provides isolation from the ventilating gases for fluids withdrawn from the patient through the manifold. When the catheter is withdrawn, it is often desired to continue regulated ventilation through the manifold. In some cases, it is desirable for the catheter assembly to be disconnected from the manifold without disturbing the ventilation of the patient. It is thus necessary to provide for a gas-tight sealing of the pathway formerly occupied by the catheter upon its removal. Previous efforts in this connection have involved the provision of auxiliary sealing structures for use in association with the manifold. These arrangements have had several disadvantages. Because they have not been integral with the manifold, their use has been inconvenient in practice. Certain resilient seals have been unacceptable because they lack the positive sealing characteristics of a mechanical valve. Available valves are not suitable for incorporation into a manifold because they lack the essential capability of providing a travel path for a catheter when catheter suction is needed. Any sealing arrangement employed should be as inexpensive as possible, thereby eliminating complex mechanical valve assemblies from practical consideration.
Manipulations, or other disturbances, of the catheter assembly tend to cause irritation to the patient and to impose strain on connection points within the assembly. These problems are alleviated to a considerable extent by the provision of a swivel capability (rotation about the longitudinal axis of the connection port) at the patient interface. Unfortunately, the provision of such a capability has heretofore involved the incorporation of swivel elements which are inordinately expensive and/or which provide an unreliable seal for the system.
Material prior art structures and methods are described, among other places, in U.S. Pat. Nos. 5,333,607 to Kee, et. al.; 5,354,267 to Niermann, et. al.; 5,357,946 and 5,445,141 to Kee, et. al. and 5,487,381 to Jinotti. These patents each disclose ventilator manifold devices and systems in which those devices are utilized.
The '267 patent, for example, discloses a manifold and a multi-position stop cock valve. The valve is provided with a "Tee" shaped internal stem channel pattern so that the stem may be positioned selectively to wash the internal lumen of a catheter, to irrigate the patient or to accommodate travel of the catheter through the stem to suction the patient. The valve may be plugged directly into an access port of the manifold. Patient ventilation is conducted without respect to the valve through other ports of the manifold. The valve itself constitutes an integral component of a catheter assembly and must be removed from the manifold with the remainder of that assembly.
There remains a need for an inexpensive, yet reliable, manifold assembly incorporating a valve positioned to minimize dead air space within the manifold and capable of passing a catheter. The valve must provide a sealed gas flow path through the manifold in both its open and closed conditions with respect to catheter travel. The manifold should further be removable from any associated catheter assembly. Ideally, the manifold should also include connection structure capable of providing a sealed passageway through a rotating or swiveling joint.